H 4326 Session 111 (1995-1996)
H 4326 General Bill, By D.C. Waldrop, Bailey, Inabinett, W.D. Keyserling,
Richardson, Seithel and Simrill
Similar(S 1020)
A Bill to amend the Code of Laws of South Carolina, 2976, by adding Section
38-71-273 so as to provide that a health benefit policy of insurance may not
require as a condition to the coverage of dermatological services that an
enrollee, subscriber, or insured first obtain a referral from a primary care
physician.
12/06/95 House Prefiled
12/06/95 House Referred to Committee on Labor, Commerce and Industry
01/09/96 House Introduced and read first time HJ-56
01/09/96 House Referred to Committee on Labor, Commerce and
Industry HJ-56
A BILL
TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA,
1976, BY ADDING SECTION 38-71-273 SO AS TO PROVIDE
THAT A HEALTH BENEFIT POLICY OF INSURANCE MAY
NOT REQUIRE AS A CONDITION TO THE COVERAGE OF
DERMATOLOGICAL SERVICES THAT AN ENROLLEE,
SUBSCRIBER, OR INSURED FIRST OBTAIN A REFERRAL
FROM A PRIMARY CARE PHYSICIAN.
Be it enacted by the General Assembly of the State of South
Carolina:
SECTION 1. The intent of the General Assembly in enacting
this act is to encourage health care cost containment while
preserving the quality of care offered to citizens of this State. The
General Assembly finds that there is an increasing number of health
insurance benefit providers which require a referral from a primary
care physician to a dermatologist as a condition of the payment of
benefits to an insured patient. The General Assembly finds that
such a requirement blocks a patient's choice of direct access to
cost-effective dermatological services and may not be in the public
interest.
SECTION 2. The 1976 Code is amended by adding:
"Section 38-71-273. (A) As used in this section, the term:
(1) `Dermatological services' means services ordinarily and
customarily rendered by a physician specializing in the practice of
dermatology.
(2) `Health benefit policy' means any individual or group
plan, policy, or contract for health care services issued, delivered,
issued for delivery, or renewed in this State by a health care
corporation, health maintenance organization, accident and sickness
insurer, fraternal benefit society, nonprofit hospital service
corporation, nonprofit medical service corporation, or similar entity.
(3) `Primary care physician' means a physician who is so
defined by a health benefit policy or elsewhere.
(B) Notwithstanding any other provision of law, a health benefit
policy of insurance issued, delivered, issued for delivery, or
renewed in this State may not require as a condition to the coverage
of dermatological services that an enrollee, subscriber, or insured
first obtain a referral from a primary care physician."
SECTION 3. This act takes effect upon approval by the
Governor and applies to health benefit policies of insurance issued,
delivered, issued for delivery, or renewed in this State on or after
July 1, 1996.
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